Texas hospital ordered to remove life support from pregnant, brain-dead woman

Erick Munoz and a photograph of himself with wife Marlise and their first son in Haltom City, Texas. (ap)

FORT WORTH, Texas – A judge on Friday ordered a Texas hospital to remove life support for a pregnant, brain-dead woman whose family had argued that she would not want to be kept in that condition.

Judge R. H. Wallace Jr. issued the ruling in the case of Marlise Munoz. John Peter Smith Hospital in Fort Worth has been keeping Munoz on life support against her family's wishes. The judge gave the hospital until 5 p.m. CST Monday to remove life support.

Munoz was 14 weeks pregnant when her husband found her unconscious Nov. 26, possibly due to a blood clot. Both the hospital and the family agree that the fetus could not be born alive at this point. However, John Peter Smith Hospital had argued that it had to protect the life of the unborn child.

Erick Munoz says he and his wife are paramedics who were clear that they didn't want life support in this type of situation. Her parents agreed. His attorney argued to the judge Friday that keeping the woman on life support would set a dangerous precedent for future cases of pregnant, brain-dead women.

Attorneys for the family declined to say what the next steps were, pending a potential appeal from the hospital.

The Tarrant County District Attorney's Office, which is representing the hospital in the lawsuit, said the hospital was expected to issue a statement later Friday in response to the ruling.

Hospital officials have said they were bound by a state law prohibiting withdrawal of treatment from a pregnant patient. Several experts interviewed by The Associated Press have said the hospital is misapplying the law because Marlise Munoz would be considered legally and medically dead.

"Marlise Munoz is dead, and she gave clear instructions to her husband and family -- Marlise was not to remain on any type of artificial `life sustaining treatment', ventilators or the like," the lawsuit said. "There is no reason JPS should be allowed to continue treatment on Marlise Munoz's dead body, and this Court should order JPS to immediately discontinue such."

The case has raised questions about end-of-life care and whether a pregnant woman who is considered legally and medically dead should be kept on life support for the sake of a fetus. It also has gripped attention on both sides of the abortion debate, with anti-abortion groups arguing Munoz's fetus deserves a chance to be born.

Earlier this week, Erick Munoz's attorneys said that the fetus, now believed to be at about 22 weeks' gestation, is "distinctly abnormal." They attorneys said they based that statement on medical records they received from the hospital.

Not much is known about fetal survival when mothers suffer brain death during pregnancy. German doctors who searched for such cases found 30 of them in nearly 30 years, according to an article published in the journal BMC Medicine in 2010.

Those mothers were further along in pregnancy -- 22 weeks on average -- when brain death occurred than in the Texas case. Birth results were available for 19 cases. In 12, a viable child was born. Follow-up results were available for six, all of whom developed normally.

In refusing to take Marlise Munoz off life support, the hospital has cited a provision of the Texas Advance Directives Act that reads: "A person may not withdraw or withhold life-sustaining treatment under this subchapter from a pregnant patient."

Experts interviewed by The Associated Press, including two who helped draft the legislation, said a brain-dead patient's case wouldn't be covered by the law.